Back pain can come suddenly through injury but for most it creeps up slowly. Niggling whispers get louder until one day they scream as nerves pinch or muscles seize, forcing you to stop and pay attention.

Back pain is the second most common reason for a doctor visit and the most prevalent work-related illness, according to the National Health Survey 2004-9. Eighty per cent of Australian adults have backache, as yoga teacher Eileen Hall attests: “Over 35 years teaching yoga, back pain is the ailment that bothers most people.”

Back pain can destabilise our serenity and security in everything including sleeping, moving, lifting, sitting, relating, working and thinking. Pain phobia can rock your foundation and kidnap your confidence. However, there are ways back from the brink. As Prince Charles’ physiotherapist Sarah Key says, “Understanding is half the cure and self-treatment is all-empowering.”

The three steps to painless freedom is learning what went wrong, rectifying it and preventing relapses.

The music of your spine

A healthy back is like a piano accordion. The 33 vertebral keys have back facet joints and side pedicles cushioned by tyre-like intervertebral discs. The spine creates a protective tunnel through which the string-like spinal cord and spinal nerves Travel. The frame is the surrounding muscles, ligaments and tendons, which give your keys stability and musical movement. Air from the bellows or lungs stretches the spine and increases circulation. The bones are kept juicy and alive with nutrients from blood vessels. These all play a part in keeping our body dancing.

What’s wrong?

Back problems can be complex, with many contributing factors. Sometimes tests and clinical examinations identify issues but not always. Don’t get disheartened if tests do show deviations from the “norm”. Many live well with “abnormal” backs as MRI research reveals it’s not uncommon to have damaged discs and no pain.

If you get diagnosed with a long Latin label, it isn’t a life sentence, just a message to tend to it. An overall optimistic, proactive and patient approach will pave your path to recovery. Beneath most baffling back issues are simple, surmountable dynamics. Your body has incredible regenerative powers and compensatory mechanisms. Embrace pain as a catalyst for positive change.

Name calling

Back problems are a whole-body imbalance rather than an isolated symptom: they arise from anywhere and affect any tissue. Spinal issues call for care by spreading to areas such as nerves (in sciatica) and muscles (in spasm). Systemic issues can originate in an organ yet manifest in the spine, such as kidney stones causing lower back pain.

Spinal disorders fit into four categories: degenerative, traumatic, inflammatory and congenital.

* Degenerative disc disorders are preceded by a stiff spinal segment caused by damage to the disc wall, usually from long-term compression, and include osteoporosis, facet joint arthropathy, prolapsed disc and spinal instability.

* Traumatic disorders include fractures, vertebral endplate ruptures, spondylolysis and disc wall trauma.

* Inflammatory disorders include rheumatoid arthritis and spondyloarthropathies.

* Congenital disorders include scoliosis, kyphosis, spinal stenosis, lumbarisation, sacralisation, spina bifida and short leg syndrome.

A spinal tumour can also cause back pain.

Back in balance

Back pain often results from neglecting your needs. Repetitive mistakes such as poor posture, movement and diet ruin a good back. Once damage is done, recovery is gradual. Repairing a bad back enlists exercise, nutrition, proper posture, relaxation, herbs and therapies. Protecting your back now is the best insurance for a pain-free future. Try these tips to sidestep setbacks.

Stand tall

How’s your position now? Is your head jutting forward, your shoulders slouched, your chest collapsed or your hips twisted? Do you feel balanced and stable?

With a soft smile, scan your body for sensations. Release soreness and tension. Squeeze an imaginary string with your urinary (PC) muscle. See that string rise straight up your spine from coccyx to crown.

Sense a helium balloon is attached to your crown. As your head drifts up, the back of your neck lengthens. Your chin tucks back with ears above your shoulders. Roll your shoulders forward, up, back and down. Open out your elbows so you feel a gap in your armpits. Breathe deep into your belly and up to raise your chest. Exhaling, brace your belly. Tuck your bum behind you using your lower back muscles and pelvic corset. Let your hips and knees soften. Spread your feet and toes flat on the floor.

Feel the difference?

It’s hard to hold this at first but with constant practice you’ll re-pattern your stance. The Gokhale Method and Alexander technique imprint your primal posture and prevent and pacify pain.

The Alexander technique was developed by Australian actor FM Alexander, whose voice was cured by being conscious of cranio-spinal alignment. After years of severe pain, posture guru Esther Gokhale discovered ways to sit, stand and move comfortably and functionally. She believes relief from therapies can only be sustained with modifications in movement and posture. Her classes teach one to re-wire the brain for better bio-dynamics. Lessons include tall standing, glidewalking, proper breathing, better bending, easier lifting, stretch sitting and hip hinging to prevent the pelvis parking forward.

Gokhale’s focus is on letting muscles relax when appropriate and tense only when required. Her Eight Steps to a Pain-Free Back is a richly illustrated instructional book offering practical pointers.

Sitting pretty

As Dr Eric Goodman of D.C Foundation Therapy explains, “Sitting at desks, hunching over devices and curling over steering wheels are daily habits that directly clash with how our bodies are designed. As a result, back pain is unprecedented in our culture.”

As I type this, I’m shifting from kneeling, standing, rolling on a ball and sitting with back support. Occasionally I get up and stretch following, Dr Goodman’s advice that one shouldn’t exceed “30 minutes in a chair without standing, deep breathing, walking and stretching”. Constant compression and stagnation from sitting will eventually cause back pain and degeneration. Yet, like sitting ducks, we spend most waking hours seated. The damage accumulates over time as discs loose lubrication.

As babies, our discs are 90 per cent water, a figure that decreases to 70 per cent by age 70. As we age, we shrink as much as 5cm from thinning discs and spinal curvatures. Sitting either while driving or at a computer strains the neck and trapezius muscle.

Sarah Keys explains, “Long hours with the heavy head dipped forward in front of the line of gravity, the trapezius must work constantly, like horses’ reins, to stop the head from dropping lower. This invokes tonic contraction of both sides of the neck for every moment you’re upright.” Hence come headaches, neck and upper back pain.

Frequent stretching and proper posture while sitting are vital. If you’re sitting now, align your head, link your hands behind you, squeezing your shoulder blades together, and raise your hands and eyes to the ceiling. This counters the stooping pose.

Kit Laughlin of Kit Laughlin Stetch Therapy shares an effective isometric neck stretch online that can be done while sitting.

Driving can disturb back pain due to the shock impact of movement, working gears, stepping on pedals, holding the steering wheel and poor posture. Choose a car that’s a little higher so it’s easy to get in and out of. An automatic also reduces asymmetrical arm movements.

Sitting properly in a car has several components. Put the seat close to the wheel so you can steer with your shoulders back and reach pedals easily. Initially, you might feel like you have tiny dinosaur arms but you’ll adjust. Use the car’s inflatable back pillow or strap a soft feather pillow to your lower back.

Back pain is the second most common reason for a doctor visit and the most prevalent work-related illness, according to the National Health Survey 2004-9.

If you spend hours sitting at a screen, you need to save your spine with proper posture. Sarah Key says, “Having the keyboard at the right height and the screen at the right distance is essential to minimise postural strain.” Aligning the arms and upper body prevents pain and chronic muscle tension called fibrosis. An ergonomic arrangement supports a relaxed body.

Esther Gokhale teaches “stretch sitting”, which entails hoisting your upper back up against the chair to decompress the lower back. She explains, “Your lengthened back muscles contribute to improved circulation, which hastens healing and helps to decompress discs and nerves.”

Vary how you sit and what you’re sitting on. Consider a fit ball, kneel in Japanese seiza position or cross-legged if flexible. Place feet on a circulation booster to counter effects of long hours sitting.

Positive posture

Do you have a “down” or “up” posture? Those with an upright, aligned posture have more energy, enthusiasm, confidence and cognitive recall, according to studies. Conversely, those with slumped, poor posture feel more fear, sadness, anger and fatigue. Good posture not only looks good, it feels good. As we emanate a more commanding, appealing presence, it increases circulation and oxygen levels from better breathing.

Standing tall raises testosterone and lowers cortisol, says psychologist Amy Cuddy, conveying confidence in others and yourself. Hunched introverts have a protective posture whereas extroverts have an empowered appearance, which may be why they’re more energetic.

Your walk also talks. A 2012 study had students walk in a slouched position then a skipping action. All students reported feeling less energy after slouching and more after skipping. Psychologist Erik Peper says slouching impedes problem solving and creative thinking. If your body expresses weakness through poor posture, your brain believes you’re weak, fuelling stress, anxiety and depression. I’ve noticed that patients with chronic back pain often have a history of depression. By improving their posture, they shift their mental state and improve their back.

Fortunately, it’s possible to “fake it till we make it”. As you retrain yourself to have better posture, you project positivity and confidence. This breeds better feelings in a biofeedback boost and new postural patterns become habitual. Try power posing to shift your state, as Cuddy recommends. “Wonder woman” pose has both feet spread apart and hands on hips. “Victory” stance has feet together, arms straight up in a V-shape and the chin tilted upward. Feel the effect?

Get up

“Sit still,” we’re told at school, but kids naturally shift position, stretching, experimenting. Animals are the same. Your body is meant to move. The best way to counter compression and stagnation from sitting or lifting is to exercise.

Your back and brain benefit from regular blood-flowing breaks. Set a reminder alarm every 30 minutes for a stretch break. Put up notes such as “posture”. Every 30 minutes, squat and stretch. Try 10 rounds of up dog to down dog. This gaps the lumbar vertebra, stretches muscles and activates the sacral pump for circulation. Hang upside-down on an inversion frame for 10 breaths or rest on a back block to unwind. Lie on your back with arms outstretched by your side, bum close to the wall and legs resting straight up the wall.

Bed bliss

A serene sleep is vital to mental and physical rejuvenation. According to Sarah Key, “A bad bed can be the undoing of a not-so-bad back. This happens when a bed that’s too soft brings a lurking stiff spinal link to the fore through lying spread out on a weaker support.”

Back pain is the second most common reason for a doctor visit and the most prevalent work-related illness, according to the National Health Survey 2004-9.

The best bed is firm yet springy enough to support movement during sleep. A pocket-spring mattress on a dense base is a therapeutic aid as it assists your spine to decompress and the discs to plump up. Says Sarah Key, “The same quantity of fluid lost by day is brought back in again by night. Our spines actually grow by nearly 2cm overnight, as discs imbibe fluid.”

Sleeping mostly symmetrically on your back reduces spinal twisting. On your side, place the upper leg over a pillow to reduce twisting. Ensure your pillow supports the gap between your head and neck, moulding to your shifting positions. During severe joint or arthritic pain, a convoluted foam mattress overlay can be a godsend. Research has revealed that patients with chronic pain using grounded carbon-fibre mattresses sleep better and experience less pain.

Free your feet

Torturous shoes are tootsie prisons, preventing feet from moving as they should. This creates physical stress through the whole body. Heavy shoes strain ankles, knees and hips. High heels throw you off balance, particularly your lower back. Unsupportive shoes affect your arches, which alters your stance. Orthotics are useful if the foot is the origin of a back problem, which is rarely the case. If there’s an anatomical leg length difference, a shoe lift can reduce symptoms.

Pamper your feet with shoes that are light and comfortable. The best shoes are nothing. Walking barefoot or in socks is an excellent way to absorb the Earth’s electrons, which are antioxidant, anti-inflammatory, alkalising and relaxing. Being barefoot stretches and strengthens stabilising muscles of the ankles and feet, improving overall balance.

Back breathing

Every breath lengthens and stretches your spine. As you exhale you stimulate lymphatics, increase circulation, massage organs and release acidic carbon dioxide.

Dr Eric Goodman suggests structured decompression breathing to improve posture and banish back pain. It lengthens hip flexors, stabilises the spine and supports the core. To do structured decompression breathing, put your thumbs at the base of your rib cage and your pinkies on your hip bones. Take three slow deep breathes with the distance between your thumbs and pinkies increasing as you inhale. Exhale with braced abdominal muscles so your ribcage doesn’t collapse. Repeat this for five breaths three times a day and gradually it will be instilled in your muscle memory.

For fresh oxygen and strong circulation, stop smoking. Smoking impedes blood flow to the spine, accelerating spinal disc degeneration.

Move mindfully

You don’t realise how you are slouching, sticking your head forward or walking weirdly until you catch your reflection or someone mentions it.

Mindful movement makes every step a dance, every gesture graceful. This is achieved by assessing your habits with ongoing awareness. When in acute pain, don’t freeze in fear. Smile, breathe deeply, touch the area, thank it for telling you and continue — consciously. Basic incorrect actions can climax as pain.

Feldenkrais offers excellent exercises to move mindfully. Functional walking, rising, sitting, lying, turning and lifting are all key to back recovery. A general rule is to maintain symmetry and equal weight on both sides. Moving from a strong core protects your back better than any brace. When in pain, reduce bending by using a pick-up stick and sit to dress.

Bra-vo

Being buxom can be a burden and back pain is the commonest reason for breast-reduction surgery. Maintaining ideal weight, strengthening muscles and wearing a supportive bra can counter the strain of a big bust.

Back pain is the second most common reason for a doctor visit and the most prevalent work-related illness, according to the National Health Survey 2004-9.

Figures estimate that up to 80 per cent of women are wearing the wrong size and type of bra. This leads to back pain, restricted breathing and poor posture. A tight bra blocks circulation and restricts breathing. An unsupportive bra causes a well-endowed woman to slump forward. Posture or encapsulation sports bras are best for large-breasted women, supporting each breast in a sturdy cup.

To ensure the correct size, get professionally fitted. Wear a bra for at least five minutes to ensure comfort. Check the shoulder straps don’t dig into you, the back doesn’t ride up and your cups don’t overflow. The centrepiece of underwired bras should sit flat against your chest and the wire should rest under your bust with no gaps.

Strengthen the inner bra of your pectoral muscles by placing your hands together in prayer and pressing your palms firmly together for three breaths. Go braless and massage your breasts daily to ensure proper circulation and lymph flow.

Work well

Back-breaking jobs demand long hours sitting, standing still and lifting or repetitive actions. Income is important but the price of a paycheque shouldn’t be your health.

Back pain can be a call to reassess your workstyle. If you can’t change your job, minor adjustments can make a major difference. Altering posture, seating, desk, location, hours, organisation and stress management can help.

If you want to change careers, start taking the necessary steps now. Wonderful work can help healing as we engage energy in meaningful pursuits. Being passionate about your profession is a health elixir whereas health declines when you lack a fulfilling occupational outlet, according to studies of unemployed and retired people.

Careful carrying

“I only have one regret in life: lifting that piano,” said a client suffering herniated discs. Sometimes our mind is stronger than our body and we think, “I can quickly carry that 50 kilo pot!” — but you’re not superhuman. Even lifting lighter weights incorrectly such as a baby on a hip can have painful repercussions. Follow these basic guidelines to lift off:

• Avoid heavy lifting.
• Use a trolley, pram, pulley, wheels or assistance.
• Carry minimal weight in your bag and wear it symmetrically. Properly fitted backpacks with stomach straps are ideal.
• Hold a baby securely on your back rather than front. Teach your child to climb independently into chairs.
• Before lifting a heavy object, gauge its weight by moving it from side to side, forward or back. Mentally rehearse how you’ll lift it. Establish a path and place where you’ll set it down. Position yourself face on, close to the object. Get a balanced, firm footing. Stand with feet shoulder width apart. Keep your back straight and perpendicular to the ground. Bend your knees, not your waist and slowly squat. Get a good grip. Tighten your core and lift with your legs, not your back. Keep your load close to your body and never above shoulder level. Never twist while lifting. Turn with feet first then your body. Take small steps. After lifting, slowly rock your pelvis back and forth or do a gentle cat stretch.

Restorative rest

Take regular gravity breaks to ease compression and tension. Horizontal meditation can be more effective than medication. Lying on a back block or in astronaut’s position gently tractions the back.

Get the mental message

“There’s nothing like a little physical pain to keep your mind off your emotional problems,” says Dr John E Sarno, author of Healing Back Pain: The Mind-Body Connection. He asserts that back pain can sometimes be a distraction to repress unconscious emotions.

The mind manifests pain messages so we focus on them instead of painful emotions. With thousands of patients, Dr Sarno found that, by accepting and addressing negative emotions, pain no longer had a purpose and disappeared. He says people prone to psychologically based pain tend to be perfectionists or people pleasers or have repressed anger and fear of activity.

Back pain can stem from many emotions. The lower back is connected with material insecurity: feeling you don’t have safety in your situation regarding relationships, Home, work and finances. Hip pain is feeling stuck. Middle back is feeling overwhelmed by people on your back. Upper back is overburdened by the weight of the world. The neck is suppressed sadness. These feelings may have no basis in reality.

Back pain is the second most common reason for a doctor visit and the most prevalent work-related illness, according to the National Health Survey 2004-9.

As Louise Hay explains, even when there’s support, people with lower back pain “don’t trust in the competence or intentions of people around them”. This leads them to criticise and over-control the situation in order to feel secure, which sabotages things more. Affirmations to clear emotional issues beneath back pain include: “Life always supports me. I trust life. I have all I need. I am secure. I am balanced. I easily flow forward.”

Superficial treatment of back pain often brings only short-term relief; long-term cure radiates from inner realisations to outer manifestations. Pain forces you to come out of emotional denial and take responsibility for your role in the problem.

See pain as your mind asking you to assess your emotions and actions, then respond with psychological and physical changes. Face money, work and relationship issues. Take an inventory of any life events that could be triggering pain and write about them. Observe meditation and dreams as mirrors of your true emotional state.

On waking, look at a picture that personifies what a strong back feels like to you. Close your eyes and see your body at its prime. Repeat “strong, stable, supported” three times. Acknowledge assistance in your life. Don’t add to suffering by feeling bad about negative emotions. Each moment be aware, accept and feel at one with reality and it will reveal your way to recovery. Once understood, pain stops talking.

Prioritise pleasure

Wallowing down in the dumps only deepens pain pathways — you’re much more than your body. Yoga teaches we’re all essentially sat, cit, ananda: eternal, omniscient, blissful beings. Detach from your pain body by increasing your inner aliveness. Feel all the pain-free areas of your body. Note all the blessings in your life. Tap into your positive life force through uplifting meditation, music, movement, a makeover, laughter, deep breathing, hobbies, nature, work, social interaction and charity — whatever makes you smile.

Treatment doesn’t have to be torture. Sometimes, just by letting go, your pain goes. This happened to Norman Cousins who, as he recounts in his book Anatomy of an Illness, laughed his agonising ankylosing spondylitis away.

Pleasure overrides pain pathways through pain-killing hormones. These euphoric endorphins alleviate the anxiety, stress and depression often paired with pain. Don’t delay in pursuing pleasure. Every night before bed, schedule three joyful things to do tomorrow. Find a way every day to show yourself love and your body will love you back.

Enlightened eating

A happy back comes from a healthy body. Ideal eating, assimilation and elimination support your back structures. Deranged digestion or diet influence the back. Blockages such as kidney stones, gall stones, endometriosis, cysts and spurs aggravate pain. Depletion from dehydration or malnutrition weakens the back. Acidity and food allergies increase inflammatory pain. Constipation, diarrhoea or prolapses strain the lower back and hips.

Ayurvedic doctor Rama Prasad perceives back pain as symptomatic of digestive problems: “Back pain is a call from your struggling internal organs. When your intestines are healthy your sacroiliac joints are better. When your liver is at ease your middle back is content. When your stomach’s smiling, your neck relaxes. When your lungs are strong, your shoulders are loose!”

Chinese abdominal massage therapy Chi Nei Tsang also treats back pain by optimising digestion. “Any spasm, blockage or toxicity from digestive organs will filter through to back bones and muscles,” says Chi Nei Tsang master Wanalee Kesornsri. Massaging your own abdomen and cleanses assist, along with the following nutrition tips:

• Check for food allergies or intolerances as inflammation and malabsorption contribute to back problems.
• Relax muscles with calcium, magnesium, phosphorus, zinc and B complex.
• Build bones with vitamin D₃, calcium citrate, magnesium, phosphorus, hydroxyapatite, boron, chondroitin, glucosamine and MSM.
• Reduce acidic inflammation with omega-3 fatty acids from fish oil, flax seed oil, mussels, salmon, sardines, tuna and trout.
• Drink at least a litre of pure water daily.
• Reduce acidic foods such as sugar, carbohydrates, trans-fatty acids, grains, oranges, alcohol, red meat, caffeine and cocoa.
• Reduce nightshade vegetables such as eggplant, tomatoes and potatoes. They aggravate arthritis as they contain solanine, an inhibitor of cholinesterase, which facilitates flexibility.
• Alkalise with alfalfa sprouts, broccoli, chlorella, kale, sodium bicarbonate and spirulina. Check first with your health provider if you have hyperthyroidism.

Back off!

Pharmaceutical pain killers and anti-inflammatories provide short-term support in back pain management. The upside is they can get you up. The downside is that they can be addictive and mask important pain signs. This allows one to do unconscious damage.

Natural anti-inflammatories include astaxanthin, curcumin, Boswellia, bromelain, rosehip and omega-3 fatty acids. External oils that may ease pain include glucosamine, magnesium, cayenne, Chinese Zheng Gu Shui and Ayurvedic Dhanwantharam oil.

Soothing essential oils include blue chamomile, camphor, frankincense, peppermint and wintergreen. Applying black sesame oil to your spine and hips once daily will relax muscles and nerves while nourishing bones.

Exercise

When movement precipitates pain we can withdraw into a sedentary shell. This is fine for a few days but it may develop into physicophobia: a fear of activity. If you rest too much you rust. Lack of circulation, stretching and strengthening causes stiffness as well as wasting, inflammation and weight gain. You need to move it or you lose it. Appropriate exercise is essential to attain and maintain health. Listen to your body and avoid aggravating exercise while opening to new moves. Try the therapeutic methods below to kiss back pain goodbye.

Spinal appeasing

During acute, intense pain you need to slowly unlock the back with very soft movements. Gentle massage, rocking and stretching will help to dissolve the stress. Once you learn to pacify pain you’ll deal with a flare-up with calm confidence. Sarah Key offers effective appeasing exercises on her video channel.

Foundation Training

Developed by chiropractor Dr Eric Goodman to overcome his own back pain, Foundation Training is a movement program that brings balance, strength and flexibility. Many professional athletes including surfer Lakey Peterson swear by it. “I had recurring lower back problems when I was younger but, since starting Foundation Training, I’ve felt constant improvement with little to no pain whatsoever,” Peterson says.

Foundation Training is a simple set of structural exercises that address the weakness underlying recurring back pain. Dr Goodman says, “By teaching you to reengage with your body and take control of your movement, health and ultimately your wellbeing, this program helps you find your physical freedom.” It recruits the core to align posture, lengthen the front of the body and fortify the back of the body.

The key exercise is called “The Founder”. As the saying goes, “a chain is only as strong as its weakest link”, so The Founder strengthens all the back links for strong, long alignment. It distributes weight evenly through the body so the lumbar spine doesn’t get dumped with constant pressure.

Stretch Therapy

Australian Kit Laughlin has shared his Stretch Therapy techniques in his classic book Overcome Neck & Back Pain. Laughlin won his own struggle with a leg-length difference and musculoskeletal issues through rigorous research and self-study. His comprehensive method uses stretching, strengthening, repatterning and relaxation.

Kit puts prime emphasis on releasing the hip flexors: “Many people’s middle-back pain and neck pain have their genesis in tight hip flexors and the consequent anteriorly tilted pelvis. Most of the tension in people’s spinal muscles is tension that is necessary to hold the person upright because of this anterior tilt. Change that and the whole body tension pattern changes. After having their hip flexors stretched, the majority of people describe the internal state of the body as literally feeling liberated.”

Yoga

Yoga adepts move with admirable poise and sit with strong, straight backs. Yoga teacher Eileen Hall says, “In most cases of back pain, with correct guidance and regular practice of yoga postures, relaxation and correct breathing techniques, the pain can be reduced and even become a past memory.”

She emphasises the importance of “working the entire spine symmetrically, breathing correctly to open the spine and stretching then strengthening in equal amounts”. Hall has discovered that “older injuries require a practice that moves from the edges to the core of the problem. New injuries, once inflammation has subsided, can often be dealt with directly.”

Yoga teacher Simon Borg-Olivier of Yoga Synergy says, “The most common cause of back pain is due to compression and excess muscle tension in the back; the simplest solution is to lengthen and relax the back.” Yoga postures for pain are best prescribed by a yoga teacher in a private session. An individualised program will ensure you avoid aggravating postures, address your specific weaknesses and receive ongoing support.

Rebounding

Get your bounce back on a mini tramp. This high-intensity exercise doesn’t jar joints so you can work out without shock impact injuries. Utah University studies found “a high-intensity workout on a rebounder’s soft surface can absorb approximately 87 per cent of impact”.

Sydney physiotherapist John Conomos recommends rebounding for recuperation: “Rebounding is a wonderful way to recover post injury. It helps gain muscle strength, recruit muscle fibres, re-educate and enhance co-ordination and balance.” It also shakes out stress and builds bone.

Pull-ups

The blue Wiggle Anthony Field is a survivor of severe back pain. He’s now pain free and fitter than ever. Field attributes this largely to a pull-up routine as detailed in his fascinating book How I Got My Wiggle Back: A Memoir of Healing. Pull-ups strengthen the upper body and core while stretching the spine. Proper form is essential with pull ups as hanging from the hands improperly strains the shoulders, arms and hands. Build up slowly and before long you’ll be swinging like Tarzan.

Pilates

Jenia Goulter is inspired by her dedicated clients at Palm Cove Pilates: “Students in their 60s with crippling pain have improved incredibly with commitment to consistent practice.”

Pilates, with its precise instructions, is a safe place to expand your back’s boundaries. It brings you back to basics by stabilising the spine and perfecting posture. Pilates tips translate into everyday life as you’re constantly replaying cues to correct alignment and engage the inner corset.

As Goulter explains, “Pilates works from inside out. You visualise the deepest muscles rippling through to the superficial layers. You learn to listen to your body and talk to it confidently.” For clients in pain, Goulter advises an initial private session to devise a personalised program.

Water works

Submerging stress in warm water can melt pain away. Water gives weightless relief whether through a borax bath, swim, hydrotherapy or Watsu water massage.

Three-dimensional, even resistance around the body provides great strength and balance training. Swimming strokes suited to stretch certain tissues and strengthen others are healing when done with alignment awareness.

Poor swimming form can create or compound back pain, however. Olympic swimmer Shayne Gould turned to the Total Immersion swimming technique to solve her shoulder problem. This teaches effective, enjoyable swimming from a strong core.

Spine solutions

One may turn to a fleet of therapists and spend squillions to cope with back pain. However, it will ultimately be conquered through constant commitment to proper posture, exercise, eating and relaxation. Therapies support your efforts but are no substitute for self-care.

Acupuncture can enlist your own chi to unblock back pain. It reprograms nerve messages from the brain to the body. The TENS tool (for Transcutaneous Electrical Nerve Stimulation) can also do this. Ayurveda has powerful body therapies for back pain. Potent herbalised oils or milk are poured or pooled over the patient to allay aches and their origin.

Those with an upright, aligned posture have more energy, enthusiasm, confidence and cognitive recall, according to studies.

Chiropractic care employs education and spinal adjustment to crack the client back into balance. Expert massage eases emotional tension, relieves pain, lowers stress chemicals, increases flexibility, stimulates lymph, reduces recovery time and realigns tissues. Osteopathic treatment is a hands-on holistic approach encompassing all tissues, employing massage and manual manipulation for integration.

Physiotherapy has three general principles of treatment, according the physiotherapist Sarah Key: separate spinal segments; condition spinal, abdominal and pelvic floor muscles to work well; and relearn normal, unselfconscious, unguarded movement. She advises, “Even with your own self-treatment, you have to make your spine do its stuff as naturally as possible. With all treatment you have to proceed carefully, using a proper proportion of appeasing exercises to proactive, mobilising and decompressing ones.”

Inversion frame

You might feel batty but hanging upside-down counters the accordion crunch of gravity. Inverting reverses the gravitational grind, aligns the spine, juices joints and frees nerves. It often gives instant relief of sciatica. In fact, a Newcastle University study showed that sciatica patients who practised inversion were 70.5 per cent less likely to require surgery.

Personal trainer Dana Eden found, “Regular inversion with my clients improved circulation, flexibility, back pain relief, reduced muscle tension, stimulated lymph flow, assisted posture correction and reduced effects of ageing due to gravity.”

An inversion frame is the ideal option as it provides support, easy transition and angle options.

Back brace or posture corrector

Bracing yourself through bumpy times can make it more bearable. Wearing a back brace or corset is like an external band of muscles giving extra support. These are particularly useful in the short term after exercise, extended sitting, prolonged standing or when lifting. Sacroiliac belts stabilise the pelvis during pregnancy and reduce hip pain. If braces are worn for too long, though, they’ll cause lazy muscles.

A study of active home health workers revealed that wearing a back brace reduced their average number of painful days by half. View the 2015 review of the best back braces.